Towards a bio-inspired control strategy for bilateral stroke rehabilitation based on motor control principles

Conventional robotic devices used for robot aided neurorehabilitation focus on unilateral training of the upper extremity post neurologic injury such as stroke, cerebral palsy etc. In this paper, we seek to establish adherence of bimanual motions of healthy and stroke subjects to the higher laws governing principles of symmetric and asymmetric division of labor in bimanual activities. As a first pass, we propose three metrics to capture these principles. We identify that the Euclidean and velocity difference metrics were able to capture key aspects of key bilateral motion control principles for the bilateral tasks studied, but may fall short if the tasks were different and asymmetric. We propose a control strategy to use the metrics to support task-oriented, bilateral stroke rehabilitation. Future work requires the development of metrics that more fully capture the motor control principles irrespective of tasks and the implementation of a bilateral controller.

[1]  E. Berton,et al.  Bimanual training in stroke: How do coupling and symmetry-breaking matter? , 2011, BMC neurology.

[2]  S. Hesse,et al.  Robot-assisted arm trainer for the passive and active practice of bilateral forearm and wrist movements in hemiparetic subjects. , 2003, Archives of physical medicine and rehabilitation.

[3]  Francesca Garbarini,et al.  Executed and imagined bimanual movements: a study across different ages. , 2014, Developmental psychology.

[4]  H.I. Krebs,et al.  Robot-Aided Neurorehabilitation: A Robot for Wrist Rehabilitation , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[5]  C.G. Burgar,et al.  Evidence for improved muscle activation patterns after retraining of reaching movements with the MIME robotic system in subjects with post-stroke hemiparesis , 2004, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[6]  W. Harwin,et al.  Multivariate analysis of the Fugl-Meyer outcome measures assessing the effectiveness of GENTLE/S robot-mediated stroke therapy , 2007, Journal of NeuroEngineering and Rehabilitation.

[7]  Y. Guiard Asymmetric division of labor in human skilled bimanual action: the kinematic chain as a model. , 1987, Journal of motor behavior.

[8]  Toshio Tsuji,et al.  Spatial characteristics of human hand impedance in multi-joint arm movements , 1994, Proceedings of IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS'94).

[9]  John McGuire,et al.  Bilateral assessment of functional tasks for robot-assisted therapy applications , 2011, Medical & Biological Engineering & Computing.

[10]  J. Whitall,et al.  Temporal coordination of the arms during bilateral simultaneous and sequential movements in patients with chronic hemiparesis , 2005, Experimental Brain Research.

[11]  Sheku Kamara,et al.  Restoring ADL function after wrist surgery in children with cerebral palsy: A novel Bilateral robot system design , 2013, 2013 IEEE 13th International Conference on Rehabilitation Robotics (ICORR).